Organization
AMERITUS ELLENDALE OPCO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM WOLFE (MANAGER)
(612) 306-5566
Entity
Organization
Contact information
Practice address
903 CALVERY COURT, ELLENDALE, MN 56026
(507) 684-3026
Mailing address
12900 WHITEWATER DRIVE, SUITE 201, MINNEAPOLIST, MN 55343-9407
(763) 537-5700
(763) 537-5700
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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